Adolescent subthreshold-depression and anxiety: psychopathology, functional impairment and increased suicide risk
Correction(s) for this article
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Erratum
- Volume 58Issue 9Journal of Child Psychology and Psychiatry
- pages: E1-E1
- First Published online: August 24, 2017
Judit Balázs
Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary
Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
Search for more papers by this authorMónika Miklósi
Semmelweis University, School of Ph.D. Studies, Budapest, Hungary
Heim Pál Paediatric Hospital, Budapest, Hungary
Search for more papers by this authorÁgnes Keresztény
Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary
Semmelweis University, School of Ph.D. Studies, Budapest, Hungary
Search for more papers by this authorChristina W. Hoven
Department of Child and Adolescent Psychiatry, Columbia University-New York State Psychiatric Institute, New York, NY, USA
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
Search for more papers by this authorVladimir Carli
National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden
Search for more papers by this authorCamilla Wasserman
Department of Child and Adolescent Psychiatry, Columbia University-New York State Psychiatric Institute, New York, NY, USA
Medicine and Health Science Department, University of Molise, Campobasso, Italy
Search for more papers by this authorAlan Apter
Feinberg Child Study Center, Schneider Children’s Medical Center, Tel Aviv University, Tel Aviv, Israel
Search for more papers by this authorJulio Bobes
Department of Psychiatry, School of Medicine, University of Oviedo; Centro de InvestigaciónBiomédica en Red de Salud Mental, CIBERSAM, Oviedo, Spain
Search for more papers by this authorRomuald Brunner
Section Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, University of Heidelberg, Heidelberg, Germany
Search for more papers by this authorDoina Cosman
Clinical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
Search for more papers by this authorPádraig Cotter
National Suicide Research Foundation, Cork, Ireland
Search for more papers by this authorChristian Haring
Research Division for Mental Health, University for Medical Information Technology (UMIT), Innsbruck, Austria
Search for more papers by this authorMiriam Iosue
Medicine and Health Science Department, University of Molise, Campobasso, Italy
Search for more papers by this authorMichael Kaess
Section Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, University of Heidelberg, Heidelberg, Germany
Orygen Youth Health Research Centre, The University of Melbourne, Melbourne, Vic., Australia
Search for more papers by this authorJean-Pierre Kahn
Department of Psychiatry, Centre Hospitalo-Universitaire (CHU) de NANCY, Université H. Poincaré, NANCY-France
Search for more papers by this authorHelen Keeley
National Suicide Research Foundation, Cork, Ireland
Search for more papers by this authorDragan Marusic
Mental Health Department, PINT, University of Primorska, Primorska, Slovenia
Search for more papers by this authorVita Postuvan
Mental Health Department, PINT, University of Primorska, Primorska, Slovenia
Search for more papers by this authorFranz Resch
Section Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, University of Heidelberg, Heidelberg, Germany
Search for more papers by this authorPilar A Saiz
Department of Psychiatry, School of Medicine, University of Oviedo; Centro de InvestigaciónBiomédica en Red de Salud Mental, CIBERSAM, Oviedo, Spain
Search for more papers by this authorMerike Sisask
Estonian-Swedish Mental Health & Suicidology Institute, Ctr. Behav & Hlth Sci, Tallinn University, Tallinn, Estonia
Search for more papers by this authorAvigal Snir
Feinberg Child Study Center, Schneider Children’s Medical Center, Tel Aviv University, Tel Aviv, Israel
Search for more papers by this authorAlexandra Tubiana
Department of Psychiatry, Centre Hospitalo-Universitaire (CHU) de NANCY, Université H. Poincaré, NANCY-France
Search for more papers by this authorAiri Varnik
Estonian-Swedish Mental Health & Suicidology Institute, Ctr. Behav & Hlth Sci, Tallinn University, Tallinn, Estonia
Search for more papers by this authorMarco Sarchiapone
Medicine and Health Science Department, University of Molise, Campobasso, Italy
Search for more papers by this authorDanuta Wasserman
National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden
Search for more papers by this authorJudit Balázs
Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary
Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
Search for more papers by this authorMónika Miklósi
Semmelweis University, School of Ph.D. Studies, Budapest, Hungary
Heim Pál Paediatric Hospital, Budapest, Hungary
Search for more papers by this authorÁgnes Keresztény
Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary
Semmelweis University, School of Ph.D. Studies, Budapest, Hungary
Search for more papers by this authorChristina W. Hoven
Department of Child and Adolescent Psychiatry, Columbia University-New York State Psychiatric Institute, New York, NY, USA
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
Search for more papers by this authorVladimir Carli
National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden
Search for more papers by this authorCamilla Wasserman
Department of Child and Adolescent Psychiatry, Columbia University-New York State Psychiatric Institute, New York, NY, USA
Medicine and Health Science Department, University of Molise, Campobasso, Italy
Search for more papers by this authorAlan Apter
Feinberg Child Study Center, Schneider Children’s Medical Center, Tel Aviv University, Tel Aviv, Israel
Search for more papers by this authorJulio Bobes
Department of Psychiatry, School of Medicine, University of Oviedo; Centro de InvestigaciónBiomédica en Red de Salud Mental, CIBERSAM, Oviedo, Spain
Search for more papers by this authorRomuald Brunner
Section Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, University of Heidelberg, Heidelberg, Germany
Search for more papers by this authorDoina Cosman
Clinical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
Search for more papers by this authorPádraig Cotter
National Suicide Research Foundation, Cork, Ireland
Search for more papers by this authorChristian Haring
Research Division for Mental Health, University for Medical Information Technology (UMIT), Innsbruck, Austria
Search for more papers by this authorMiriam Iosue
Medicine and Health Science Department, University of Molise, Campobasso, Italy
Search for more papers by this authorMichael Kaess
Section Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, University of Heidelberg, Heidelberg, Germany
Orygen Youth Health Research Centre, The University of Melbourne, Melbourne, Vic., Australia
Search for more papers by this authorJean-Pierre Kahn
Department of Psychiatry, Centre Hospitalo-Universitaire (CHU) de NANCY, Université H. Poincaré, NANCY-France
Search for more papers by this authorHelen Keeley
National Suicide Research Foundation, Cork, Ireland
Search for more papers by this authorDragan Marusic
Mental Health Department, PINT, University of Primorska, Primorska, Slovenia
Search for more papers by this authorVita Postuvan
Mental Health Department, PINT, University of Primorska, Primorska, Slovenia
Search for more papers by this authorFranz Resch
Section Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, University of Heidelberg, Heidelberg, Germany
Search for more papers by this authorPilar A Saiz
Department of Psychiatry, School of Medicine, University of Oviedo; Centro de InvestigaciónBiomédica en Red de Salud Mental, CIBERSAM, Oviedo, Spain
Search for more papers by this authorMerike Sisask
Estonian-Swedish Mental Health & Suicidology Institute, Ctr. Behav & Hlth Sci, Tallinn University, Tallinn, Estonia
Search for more papers by this authorAvigal Snir
Feinberg Child Study Center, Schneider Children’s Medical Center, Tel Aviv University, Tel Aviv, Israel
Search for more papers by this authorAlexandra Tubiana
Department of Psychiatry, Centre Hospitalo-Universitaire (CHU) de NANCY, Université H. Poincaré, NANCY-France
Search for more papers by this authorAiri Varnik
Estonian-Swedish Mental Health & Suicidology Institute, Ctr. Behav & Hlth Sci, Tallinn University, Tallinn, Estonia
Search for more papers by this authorMarco Sarchiapone
Medicine and Health Science Department, University of Molise, Campobasso, Italy
Search for more papers by this authorDanuta Wasserman
National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden
Search for more papers by this authorConflicts of interest statement: No conflicts declared.
Abstract
Background: Subthreshold-depression and anxiety have been associated with significant impairments in adults. This study investigates the characteristics of adolescent subthreshold-depression and anxiety with a focus on suicidality, using both categorical and dimensional diagnostic models.
Methods: Data were drawn from the Saving and Empowering Young Lives in Europe (SEYLE) study, comprising 12,395 adolescents from 11 countries. Based on self-report, including Beck Depression Inventory-II (BDI-II), Zung Self-Rating Anxiety Scale (SAS), Strengths and Difficulties Questionnaire (SDQ) and Paykel Suicide Scale (PSS) were administered to students. Based on BDI-II, adolescents were divided into three groups: nondepressed, subthreshold-depressed and depressed; based on the SAS, they were divided into nonanxiety, subthreshold-anxiety and anxiety groups. Analyses of Covariance were conducted on SDQ scores to explore psychopathology of the defined groups. Logistic regression analyses were conducted to explore the relationships between functional impairments, suicidality and subthreshold and full syndromes.
Results: Thirty-two percent of the adolescents were subthreshold-anxious and 5.8% anxious, 29.2% subthreshold-depressed and 10.5% depressed, with high comorbidity. Mean scores of SDQ of subthreshold-depressed/anxious were significantly higher than the mean scores of the nondepressed/nonanxious groups and significantly lower than those of the depressed/anxious groups. Both subthreshold and threshold-anxiety and depression were related to functional impairment and suicidality.
Conclusions: Subthreshold-depression and subthreshold-anxiety are associated with an increased burden of disease and suicide risk. These results highlight the importance of early identification of adolescent subthreshold-depression and anxiety to minimize suicide. Incorporating these subthreshold disorders into a diagnosis could provide a bridge between categorical and dimensional diagnostic models.
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